UNKNOWN

FEED

Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: ' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women. ' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Harris Health is a nationally recognized health system comprising three teaching hospitals and an extensive network of ambulatory care centers serving the people of Harris County, Texas, since 1966. Staffed by the faculty, fellows and residents from two nationally ranked medical schools, Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth), Harris Health is the first healthcare system in Houston to receive the prestigious National Committee for Quality Assurance (NCQA) designation for its network of patient-centered medical homes.

Each year, Harris Health provides more than 1.8 million total outpatient visits through its more than 40 ambulatory care facilities. Additionally, Harris Health sees more than 177,000 emergency visits at its Level 1 and Level 3 trauma centers and 35,000 hospital admissions through its three hospitals: Ben Taub, LBJ and Quentin Mease. Established by voter referendum to enhance the level of charity care available in the community, Harris Health System has often received national recognition for serving those in need and for its achievements in operational excellence, such as being named to the 2011, 2012, 2013 and 2014 Most Wired Hospitals lists by the American Hospital Association's Hospitals & Health Networks magazine.

Additionally, Harris Health System is pleased that each of its three hospitals: Ben Taub, Lyndon B. Johnson and Quentin Mease - achieved Pathway to Excellence designation by the American Nurses Credentialing Center.

Harris Health System

Care Management Nurse RN

This employee must be service oriented and have excellent customer service skills, computer skills, critical thinking skills, problem-solving skills, organizational skills, multitasking skills, professional interpersonal skills, time management skills, the ability to prioritize work, the ability to work in a team, and telephone etiquette. This position requires operational knowledge of all equipment in the Care Resource Management department, including: fax, printers, copy machine, phone systems, and commonly used association-wide computer programs (including Hospital Information Systems, MS Office, e-mail, and internet).

Summit Healthcare External

RN Case Manager - PRN

The Care Manager, RN provides leadership in the coordination of patient-centered care across the continuum, develops a safe discharge plan through collaboration with the patients/caregivers and multidisciplinary healthcare team to arrange appropriate post discharge services and optimal transitions in care. Continuum of Care planning will emphasize education and collaboration with physicians, family members, clinical social workers, nursing staff, therapists, and case managers from contracted payors when appropriate to determine discharge plan that will be of maximum benefit to the patient.

YEAR

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

<a href="https://www.youtube.com/watch?v=5PbNyi2IDkY">https://www.youtube.com/watch?v=5PbNyi2IDkY</a> 

Caring. Connecting. Growing together. 

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

• Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. <a href="https://careers.unitedhealthgroup.com/culture/what-we-offer/">Learn more about what we offer.</a> 

• Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. <a href="https://careers.unitedhealthgroup.com/culture/">Learn more about our culture.</a> 

• Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. <a href="https://careers.unitedhealthgroup.com/career-areas/">Discover all the ways you can learn, grow and develop.</a>

UnitedHealth Group Inc

Case Manager RN

Education and Experience Required: Four (4) years of nursing experience in case management, utilization review, utilization management, or discharge planning including one (1) year of nursing leadership experience. Coordinates departmental activities by scheduling work assignments, establishing priorities, and directing the work of case managers.

University of Mississippi Medical Center

Manager - Case Management - RN - Coordinated Care

Case Manager Registered Nurse

As the Clinical Resource Management Nurse Lead, you'll provide day-to-day leadership for the Clinical Resource Management department, overseeing staffing, assignments, and daily operations while maintaining 24-hour accountability for planning, managing, and evaluating department functions. Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors).

Children's Hospital

Clinical Resource Management Nurse Lead

Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology.

HOUR

Mount Sinai Health System

Mount Sinai Hospital - RN Case Manager Interview Day - August 12 - Invite Only

Demonstrates competencies of clinical reasoning and critical-thinking skills for managing complex and high-risk patients while simultaneously assuming the patient advocate role to ensure conflict-free, unbiased and culturally competent care. Ensures operation of equipment by completing preventive maintenance requirements; following manufacturer's instructions; troubleshooting malfunctions; calling for repairs; maintaining equipment inventories; evaluating new equipment and techniques.

Independence Health System

Case Manager - RN

ea_via_bold

SUMMARY: The Utilization Management Authorization Review Nurse is responsible for managing inpatient & outpatient utilization by conducting thorough reviews of clinical documentation and applying clinical knowledge in accordance with relevant Care Guidelines and CMS regulations. This policy relates to all phases of employment, including but not limited to recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company sponsored employee activities.

Astiva Health, Inc.

UM Nurse Reviewer

Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system. General Summary: Responsible for the review of inpatient and outpatient admission records for appropriate admission status at Mercy Medical Center and Mercy West Lakes.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, the Trinity Health system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. In fiscal year 2023, the Livonia, Michigan-based health system invested $1.5 billion in its communities in the form of charity care and other community benefit programs.

Trinity Health

Demonstrates competencies of clinical reasoning and critical-thinking skills for managing complex and high-risk patients while simultaneously assuming the patient advocate role to ensure conflict-free, unbiased and culturally competent care. Ensures operation of equipment by completing preventive maintenance requirements; following manufacturers instructions; troubleshooting malfunctions; calling for repairs; maintaining equipment inventories; evaluating new equipment and techniques.

CASE MANAGER - RN

Communicates with and educates physicians as needed regarding discharge planning policies, practices, and procedures to ensure safe, effective services, along with appropriate transitions of care for hospital patients at time of discharge. Works closely with physicians and staff to provide and monitor clinical/financial data for the purpose of improving hospital/Physician performance and anticipating payer and managed care demands.

Northeast Georgia Health System

Registered Nurse - (Rn) - Case Manager - Supervisor

As needed, provides a nursing assessment within 24-48 hours of patient admission for clinically oriented services focused on mobilizing primary care physician, hospital systems, patient/family and community resources directed towards facilitating a clinically safe and timely discharge. Maintains a professional working relationship with Managed Care Organization telephonic and on site reviewers and external reviewing agencies in monitoring course of hospitalization and need for post hospital services according to third party payor guidelines.

Brown University Health

SAH RN Case Manager

SAH RN Case Manager EX

Collaborates with the Verification department, Revenue cycle and Medical Eligibility to facilitate the establishment of the correct payer source for patient stay and the documentation of the interactions in the STAR admitting system. Works in collaboration with the attending physician and the Case Management staff utilizing admission criteria guidelines-and second level physician review process when appropriate.

ER Case Manager RN Weekends

Participate in clinical performance/quality improvement teams within the department, service lines, and hospital to identify opportunities for improvement in such areas as clinical outcomes, length of stay management, and utilization of resources; use data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical and patient satisfaction data. Provide case management assessment and interventions based on initial screening for discharge needs, identify readmission risks, patient strengths and needs related to transition and discharge planning; collaborate and communicate with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching, ongoing evaluation, and medical readiness for discharge.

Utilization Review Nurse Jobs in the United States

Care Management Nurse RN Harris Health System

RN Case Manager - PRN Summit Healthcare External

Case Manager RN UnitedHealth Group Inc

Manager - Case Management - RN - Coordinated Care University of Mississippi Medical Center

Case Manager Registered Nurse UnitedHealth Group Inc

Clinical Resource Management Nurse Lead Children's Hospital

Mount Sinai Hospital - RN Case Manager Interview Day - August 12 - Invite Only Mount Sinai Health System

Case Manager - RN Independence Health System

UM Nurse Reviewer Astiva Health, Inc.

Case Manager RN Trinity Health

CASE MANAGER - RN Independence Health System

Registered Nurse - (Rn) - Case Manager - Supervisor Northeast Georgia Health System

SAH RN Case Manager Brown University Health

SAH RN Case Manager EX Brown University Health

ER Case Manager RN Weekends Trinity Health

Case Manager (RN) - Stanyan UCSF Medical Center

ED RN Case Manager Nights Trinity Health

Case Manager RN Weekend Days Trinity Health

Case Manager RN Weekends Trinity Health

Registered Nurse - (RN) - Case Manager - Supervisor Northeast Georgia Health System Inc

Similar Job Searches

See More Jobs

Stand out to leading employers.